A Computational and Experimental Study to Compare the Effectiveness of Bipolar Mode With Phase-Shift Angle Mode in Radiofrequency Fat Dissolution on Subcutaneous Tissue.

BACKGROUND AND OBJECTIVES

Radiofrequency (RF) energy exposure refers to a popular non-invasive method employed to generate heat in cutaneous and subcutaneous tissues. RF thermal stimulation of adipose tissue has been considered to cause adipocyte metabolism and enzymatic degradation of triglycerides into free fatty acids and glycerol. Bipolar mode (BM) has achieved extensive applications in clinical studies on RF fat dissolution, whereas BM has a less penetration depth than monopolar, result in a higher RF voltage that may be required to increase power to the deeper fat layer of the subcutaneous tissue, and improper power control may easily cause the skin layer to be thermally damaged. To tackle down the mentioned defect, a novel phase-shift angle mode (PM) was proposed in this study based on double-channel bipolar RF. By employing the finite element method (FEM) and performing the ex vivo experiment, the effectiveness of BM was compared with that of PM in RF fat dissolution on subcutaneous tissue. In addition, this study attempted to develop reasonable phase-shift angles capable of achieving fat dissolution effects, while the RF energy of which would not cause the skin layer to be thermally damaged.

STUDY DESIGN/MATERIALS AND METHODS: Two electrode spacings (1 and 2 cm) were applied in BM (BM-1 cm and BM-2 cm, respectively), and six phase-shift angles (i.e., 30°, 60°, 90°, 120°, 150°, and 180°) were set in PM (i.e., PM-30°, PM-60°, PM-90°, PM-120°, PM-150°, and PM-180°). In addition, COMSOL was adopted to conduct a finite element analysis for achieving thermoelectric coupling. Ex vivo experiments were performed with a self-developed double-channel bipolar RF device, through which up to two adjustable phase-shift angle sinusoidal voltages could be generated. Such a device was isolated with a transformer and then connected to four electrodes with a 5 mm diameter contacting the ex vivo porcine abdominal tissue.

RESULTS

Under the RF voltage amplitude of 30 V, and after 1800 seconds of RF heating, no thermally damaged area was formed in the tissue in BM-1 cm and BM-2 cm; in PM-30°, PM-60°, and PM-90°, thermally damaged areas were formed in the fat layer, while the skin layer was not located in the thermally damaged area. Moreover, the temperature in the thermally damaged area attributed to the mentioned three conditions may satisfy the requirement of fat dissolution temperature.

CONCLUSIONS

Under the identical RF voltage and heating time, PM is easier to cause the fat layer of the subcutaneous tissue to be thermally damaged as compared with BM. Accordingly, PM may be enabled to achieve the fat dissolution effect under a relatively low RF voltage as opposed to BM, thus avoiding the possibility of thermal damage of the skin layer attributed to the use of higher RF voltage. In PM, different phase-shift angle significantly affects the electrical and thermal properties of RF energy applied on subcutaneous tissue; the phase-shift angle of RF voltage is likely to be regulated for fat dissolution effect, while the RF energy of which will not cause the skin layer to be thermally damaged.© 2021 Wiley Periodicals LLC.